Fast Five Quiz: Aortic Stenosis

Yasmine S. Ali, MD

Disclosures

June 25, 2019

Congenitally unicuspid, bicuspid, tricuspid, or even quadricuspid valves may cause aortic stenosis. In neonates and infants younger than 1 year, a unicuspid valve can produce severe obstruction and is the most common anomaly in infants with fatal valvular aortic stenosis. In patients younger than 15 years, unicuspid valves are most frequent in cases of symptomatic aortic stenosis.

The main causes of acquired aortic stenosis include degenerative calcification and, less commonly, rheumatic heart disease. Degenerative calcific aortic stenosis (also called senile calcific aortic stenosis) involves progressive calcification of the leaflet bodies, resulting in limitation of the normal cusp opening during systole. In rheumatic aortic stenosis, the underlying process includes progressive fibrosis of the valve leaflets with varying degrees of commissural fusion, often with retraction of the leaflet edges and, in certain cases, calcification.

Most patients with a congenitally bicuspid aortic valve who develop symptoms do not do so until middle age or later. Patients with rheumatic aortic stenosis typically present with symptoms after the sixth decade of life. Degenerative calcific aortic stenosis usually manifests in individuals older than 65 years, and occurs most frequently in males.

Read more about aortic stenosis.

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